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Individual

JESSICA LYN LALA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LCSW

Contact information

Practice address
56218 PARKWAY AVE, SUITE B, ELKHART, IN 46516-9326
(574) 293-0005
(574) 293-0019
Mailing address
56218 PARKWAY AVE, SUITE B, ELKHART, IN 46516-9326
(574) 293-0005
(574) 293-0019

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
99052119A
IN

Other

Enumeration date
07/02/2012
Last updated
10/03/2013
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